Correlation of Short Form-36 and Disability Status with Outcomes of Arthroscopic Acetabular Labral Debridement

2005 ◽  
Vol 33 (6) ◽  
pp. 864-870 ◽  
Author(s):  
Benjamin K. Potter ◽  
Brett A. Freedman ◽  
Romney C. Andersen ◽  
John A. Bojescul ◽  
Timothy R. Kuklo ◽  
...  
Keyword(s):  
Hip Arthroscopy ◽  
Short Form ◽  
Harris Hip Score ◽  
Arthroscopic Debridement ◽  
Short Form 36 ◽  
Significant Difference ◽  
Patient Reported ◽  
Disability Status ◽  
Modified Harris Hip Score ◽  
The Impact

Background Arthroscopic debridement is the standard of care for the treatment of acetabular labral tears. The Short Form-36 has not been used to measure hip arthroscopy outcomes, and the impact of disability status on hip arthroscopy outcomes has not been reported. Hypothesis Short Form-36 subscale scores will demonstrate good correlation with the modified Harris hip score, but patients undergoing disability evaluation will have significantly worse outcome scores. Study Design Case series; Level of evidence, 4. Methods The records of active-duty soldiers who underwent hip arthroscopy at the authors’ institution were retrospectively reviewed. Forty consecutive patients who underwent hip arthroscopy for the primary indication of labral tear formed the basis of the study group. Patients completed the modified Harris hip score, the Short Form-36 general health survey, and a subjective overall satisfaction questionnaire. Results Thirty-three patients, with a mean age of 34.6 years, were available for follow-up at a mean of 25.7 months postoperatively. Fourteen (43%) patients were undergoing medical evaluation boards (military equivalent of workers’ compensation or disability claim). Pearson correlation coefficients for comparing the Short Form-36 Bodily Pain, Physical Function, and Physical Component subscale scores to the modified Harris hip score were 0.73, 0.71, and 0.85, respectively (P <. 001). The mean modified Harris hip score was significantly lower in patients on disability status than in those who were not (92.4 vs 61.1; P <. 0001). The Short Form-36 subscale scores were significantly lower in disability patients (P <. 02). Patient-reported satisfaction rates (70% overall) were 50% for those undergoing disability evaluations and 84% for those who were not (P <. 04). There was no significant difference in outcomes based on patient age, surgically proven chondromalacia, or gender for military evaluation board status. Conclusion The Short Form-36 demonstrated good correlation with the modified Harris hip score for measuring outcomes after arthroscopic partial limbectomy. Arthroscopic debridement yielded a high percentage of good results when patients undergoing disability evaluations were excluded. Disability status may be a negative predictor of success after hip arthroscopy.

scholarly journals Is There a Gender Gap in Outcomes After Hip Arthroscopy for Femoroacetabular Impingement? Assessment of Clinically Meaningful Improvements in a Prospective Cohort

2020 ◽  
Vol 8 (7) ◽  
pp. 232596711990056
Author(s):  
Sergio E. Flores ◽  
Caitlin C. Chambers ◽  
Kristina R. Borak ◽  
Alan L. Zhang
Keyword(s):  
Femoroacetabular Impingement ◽  
Gender Gap ◽  
Hip Arthroscopy ◽  
Short Form ◽  
Patient Reported Outcome ◽  
Harris Hip Score ◽  
Age Group ◽  
Level Of Evidence ◽  
Patient Reported ◽  
Modified Harris Hip Score

Background: Although patients have experienced significant improvements after hip arthroscopy for femoroacetabular impingement (FAI), prior studies suggest that women have worse outcomes than men. These previous studies lack comparisons of patient-reported outcome (PRO) scores based on gender with respect to clinical significance measurements, including the minimal clinically important difference (MCID) and patient acceptable symptom state (PASS). Purpose: To evaluate outcomes after hip arthroscopy for FAI based on patient gender by prospectively assessing changes in PRO scores, MCID, and PASS. Study Design: Cohort study; Level of evidence, 2. Methods: Women and men undergoing hip arthroscopy for FAI were prospectively enrolled, and preoperative radiographic and intraoperative findings were collected. Patients completed the following PRO surveys before surgery and 2 years postoperatively: modified Harris Hip Score (mHHS), Hip disability and Osteoarthritis Outcome Score (HOOS), and 12-Item Short Form Health Survey. Mean scores and percentage of patients reaching MCID and PASS were analyzed. Results: A total of 131 hips were included (72 women, 59 men). Women had smaller preoperative alpha angles (59.1° vs 63.7°, respectively; P < .001) and lower acetabular cartilage injury grade (6.9% vs 22.0% with grade 4 injury, respectively; P = .013). Both women and men achieved equivalent significant improvements in PRO scores after surgery (scores increased 18.4 to 45.1 points for mHHS and HOOS). Women and men reached PASS for mHHS at similar rates (76.4% and 77.2%, respectively; P = .915). MCID was also achieved at similar rates between women and men for all scores (range, 61.4%-88.9%) except the activities of daily living subscale of the HOOS, in which a greater percentage of women reached MCID compared with men (79.2% vs 62.7%, respectively; P = .037). Additional stratification by age group using the median cohort age of 34 years showed no significant differences in PRO improvement based on age group for each gender. Conclusion: Women can achieve clinically meaningful improvements in PRO scores after hip arthroscopy for FAI. Compared with men, women demonstrated equivalent high rates of achieving MCID and PASS at 2 years after surgery.

Clinical and Radiographic Presentation of Capsular Iatrogenic Hip Instability After Previous Hip Arthroscopy

2020 ◽  
Vol 48 (12) ◽  
pp. 2927-2932
Author(s):  
Dillon C. O’Neill ◽  
Alexander J. Mortensen ◽  
Peter C. Cannamela ◽  
Stephen K. Aoki
Keyword(s):  
Hip Arthroscopy ◽  
Daily Living ◽  
Patient Reported Outcomes ◽  
Harris Hip Score ◽  
Hip Instability ◽  
Computer Adaptive Test ◽  
Adaptive Test ◽  
Patient Reported ◽  
Modified Harris Hip Score

Background: The clinical and radiographic features of iatrogenic hip instability following hip arthroscopy have been described. However, the prevalence of presenting symptoms and associated imaging findings in patients with hip instability has not been reported. Purpose: To detail the prevalence of clinical and magnetic resonance arthrogram (MRA) findings in a cohort of patients with isolated hip instability and to determine midterm patient-reported outcomes in this patient population. Study Design: Case series; Level of evidence, 4. Methods: We retrospectively reviewed patients from 2014 to 2016 who underwent an isolated capsular repair in the revision hip arthroscopy setting. Patients were excluded if they underwent any concomitant procedures, such as labral repair, reconstruction, femoral osteoplasty, or any other related procedure. Several clinical data points were reviewed, including painful activities, mechanical symptoms, subjective instability, Beighton scores, axial distraction testing (pain, toggle, and apprehension), and distractibility under anesthesia. Patient-reported outcomes—including modified Harris Hip Score, Hip Outcome Score–Sports Subscale, Patient-Reported Outcome Measurement Information System (PROMIS) Physical Function Computer Adaptive Test, and a return patient hip questionnaire—were collected pre- and postoperatively. Pre-revision radiographs were obtained, and lateral center-edge angle and alpha angle were measured on anteroposterior and frog-leg lateral views, respectively. Pre-revision MRAs were reviewed and evaluated for capsular changes. Capsular changes were defined as follows: 0, normal; 1, capsular redundancy; 2, focal capsular rent; and 3, gross extravasation of fluid from the capsule. Results: A total of 31 patients met inclusion criteria (5 male, 26 female; 14 right and 17 left hips). The mean age of patients was 36 years (range, 20-58 years). Overall, 27 (87%) reported hip pain with activities of daily living, and 31 (100%) experienced pain with sports or exercise. In addition, 24 (77%) had at least 1 positive finding on axial distraction testing. All patients had evidence of capsular changes on review of pre-revision MRAs. Out of 31 patients, 23 (74%) were available for follow-up at a minimum of 3.3 years and a mean ± SD of 4.6 ± 0.8 years. On average, modified Harris Hip Score improved by 20.3, Hip Outcome Score–Sports Subscale by 25.1, and PROMIS Physical Function Computer Adaptive Test by 6.4. Additionally, 20 (87%) patients reported improved or much improved physical ability, and 18 (78%) reported improved or much improved pain. Conclusion: The current study suggests that patients with hip instability demonstrate high rates of pain with activities of daily living and exercise, positive findings on axial distraction testing, and evidence of capsular changes on magnetic resonance imaging. Furthermore, these patients improve with revision surgery for capsular repair at midterm follow-up.

scholarly journals Return to Sport Rates and Functional Outcomes Following Bilateral Hip Arthroscopy in High-Level Athletes

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0043
Author(s):  
Benjamin Domb ◽  
Cynthia Kyin ◽  
Jacob Shapira ◽  
David Maldonado ◽  
Ajay Lall ◽  
...  
Keyword(s):  
Hip Arthroscopy ◽  
Patient Reported Outcomes ◽  
Return To Sport ◽  
Harris Hip Score ◽  
Complication Rates ◽  
Professional Athlete ◽  
Patient Reported ◽  
High Level ◽  
Modified Harris Hip Score

Objectives: To determine the rate of return to sport (RTS) in high-level athletes undergoing bilateral hip arthroscopy and report minimum 1-year patient-reported outcomes (PROs) for this cohort. We hypothesized that RTS rates, as well as sport-specific PROs, will be lower than the rates and scores previously reported in the literature for unilateral hip arthroscopy. Methods: Data were prospectively collected on all patients undergoing hip arthroscopy at our institution from November 2011 to July 2018. Patients were included if they underwent bilateral hip arthroscopy and were either a high school, collegiate, or professional athlete prior to their first surgery. RTS was defined as a patient’s return to competitive participation in their respective sport. Additional PROs, including modified Harris Hip Score (mHHS), nonarthritic hip score (NAHS), and Hip Outcome Score-Sports Specific Subscale (HOS-SSS), as well as complication rates and future surgeries were documented and compared for all patients. Results: A total of 87 patients met inclusion criteria, for which follow-up was available for 82 (94.3%). At latest follow-up, 44 (53.7%) patients returned to sport. Of patients returning, 56% did so at the same level or higher. The most common reasons for not returning to sport were due to graduation/lifestyle change (47.4%) and hip symptoms (44.7%). Patients returning to sport had significantly higher PROs at latest follow-up relative to those who did not return, including for mHHS (93.7 vs. 87.5), NAHS (94.4 vs. 88.2), HOS-SSS (90.9 vs. 78.2) (P < 0.05). Rates of achieving PASS and MCID for mHHS were not significantly different. However, for HOS-SSS, patients who returned had significantly higher rates of achieving the MCID and PASS. Conclusion: Rates of RTS after bilateral hip arthroscopy are lower than those after unilateral hip arthroscopy. When comparing patients that returned to sports and those who did not return, we show that although both groups show a significant improvement in PROs following surgery, those that returned to sport achieved significantly higher scores in all outcome measures. In addition, patients returning to sports showed a significantly higher rate of attaining MCID and PASS scores for the HOS-SSS, possibly attesting to the validity of this score and its thresholds.

scholarly journals Return to Play After Hip Arthroscopy Among Tennis Players: Outcomes with Minimum Five-Year Follow-up

2019 ◽  
Author(s):  
David R. Maldonado ◽  
Mitchell J. Yelton ◽  
Philip J. Rosinsky ◽  
Jacob Shapira ◽  
Mitchell Meghpara ◽  
...  
Keyword(s):  
Hip Arthroscopy ◽  
Arthroscopic Surgery ◽  
Return To Sport ◽  
Return To Play ◽  
Harris Hip Score ◽  
Tennis Players ◽  
Labral Tears ◽  
Patient Reported ◽  
Modified Harris Hip Score

Abstract Background: Playing tennis is associated with various movements that can lead to labral injuries and may require arthroscopic surgery. While hip arthroscopies have demonstrated good outcomes in athletes, there is limited literature reporting Patient Reported Outcomes (PROs) and return to play in competitive or recreational tennis players after hip arthroscopic surgery. Therefore, the purpose of the present study was to (1) report minimum five-year PROs and return to sport in tennis players who underwent hip arthroscopic surgery and (2) compare outcomes between recreational and competitive tennis players. Methods: Data for patients who underwent hip arthroscopy surgery in the setting of femoroacetabular impingement (FAI) and labral tears between March 2009 and January 2014 and who played tennis at any level within one-year of surgery were retrospectively reviewed. Patients with preoperative and minimum five-year postoperative scores for the following PROs were included: modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Sport Specific Subscale (HOS-SSS), and visual analog scale (VAS) for pain. Patients with preoperative Tönnis osteoarthritis Grade >1, Workers’ Compensation claims, age > 60 years old, or previous ipsilateral hip surgeries or conditions were excluded. Patient Acceptable Symptomatic State (PASS) and Minimal Clinically Important Difference (MCID) for mHHS and HOS-SSS were calculated. Results: Of 28 patients, 31 hips met all inclusion and exclusion criteria of which 28 (90.3%) had minimum 5-year follow-up (mean: 72.8 ± 13.9 months). There were 3 professional, 3 collegiate, 2 high school, 2 organized amateur, and 18 recreational level tennis players. All PROs significantly improved at latest follow-up: mHHS from 67.0 to 86.7 (P < 0.001), NAHS from 65.9 to 87.2 (P < 0.001), HOS-SSS from 50.0 to 77.9 (P = 0.009), and VAS from 5.4 to 1.8 (P < 0.001). There was a 75.0% return to sport rate. Additionally, 66.7% of patients achieved MCID and 83.3% achieved PASS for mHHS, and 63.6% achieved MCID and 58.3% achieved PASS for HOS-SSS. Conclusion: Regardless of the level of participation, tennis players who underwent hip arthroscopic surgery reported statistically significant PRO improvements. A favorable rate of return to sport was also achieved.

scholarly journals Defining the Minimal Clinically Important Difference in Athletes Undergoing Arthroscopic Correction of Sports-Related Femoroacetabular Impingement: The Percentage of Possible Improvement

2020 ◽  
Vol 8 (1) ◽  
pp. 232596711989474 ◽  
Author(s):  
Patrick Carton ◽  
David Filan
Keyword(s):  
Femoroacetabular Impingement ◽  
Minimal Clinically Important Difference ◽  
Harris Hip Score ◽  
Baseline Score ◽  
Clinically Important Difference ◽  
Sf 36 ◽  
Significant Difference ◽  
Patient Reported ◽  
Ceiling Effects ◽  
The Impact

Background: Measures of clinically meaningful improvement in patient-reported outcomes within orthopaedics are becoming a minimum requirement to establish the success of an intervention. Purpose: To (1) define the minimal clinically important difference (MCID) at 2 years postoperatively in competitive athletes undergoing hip arthroscopic surgery for symptomatic, sports-related femoroacetabular impingement utilizing existing anchor- and distribution-based methods and (2) derive a measure of the MCID using the percentage of possible improvement (POPI) method and compare against existing techniques. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: There were 2 objective outcome measures—the modified Harris Hip Score (mHHS) and 36-Item Short Form Health Survey (SF-36)—administered at baseline and 2 years postoperatively. External anchor questions were used to determine the MCID through mean change, mean difference, and receiver operating characteristic (ROC) techniques. Distribution-based calculations consisted of 0.5 SD, effect size, and standard error of measurement techniques. The POPI was calculated alongside each technique as an achieved percentage change of maximum available improvement for each athlete relative to the individual baseline score. The impact of the preoperative baseline score on the MCID was assessed by assigning athletes to groups determined by baseline percentiles. Statistical analysis was performed, with P < .05 considered significant. Results: There were 576 athletes (96% male; mean age, 25.9 ± 5.7 years). The MCID score change (and POPI) for the mHHS and SF-36 ranged from 2.4 to 16.7 (21.6%-63.6%) and from 3.3 to 24.9 (22.1%-57.4%), respectively. The preoperative threshold value for achieving the ROC-determined MCID was 80.5 and 86.5 for the mHHS and 70.1 and 72.4 for the SF-36 for the patient-reported outcome measure (PROM) score– and POPI-calculated MCID, respectively. Through the commonly used mean change method, 40.0% (mHHS) and 42.4% (SF-36) of athletes were unable to achieve the MCID because of high baseline scores and PROM ceiling effects compared with 0% when the POPI technique was used. A highly significant difference for the overall MCID was observed between preoperative baseline percentile groups for the mHHS ( P = .014) and SF-36 ( P = .004) (improvement in points), while there was no significant difference between groups for either the mHHS ( P = .487) or SF-36 ( P = .417) using the POPI technique. Conclusion: The MCID defined by an absolute value of improvement was unable to account for postoperative progress in a large proportion of higher functioning athletes. The POPI technique negated associated ceiling effects, was unrestricted by the baseline score, and may be more appropriate in quantifying clinically important improvement.

scholarly journals Bilateral versus unilateral hip arthroscopy for femoroacetabular impingement: a systematic review

2020 ◽  
Vol 7 (2) ◽  
pp. 225-232
Author(s):  
Claire E Fernandez ◽  
Allison M Morgan ◽  
Ujash Sheth ◽  
Vehniah K Tjong ◽  
Michael A Terry
Keyword(s):  
Systematic Review ◽  
Femoroacetabular Impingement ◽  
Hip Arthroscopy ◽  
Case Reports ◽  
Case Series ◽  
Return To Sport ◽  
Harris Hip Score ◽  
Study Patient ◽  
Significant Difference ◽  
Patient Reported

Abstract One in four patients presenting with femoroacetabular impingement (FAI) has bilateral symptoms, and despite excellent outcomes reported after arthroscopic treatment of FAI, there remains a paucity of data on the outcomes following bilateral hip arthroscopy. This systematic review aims to examine the outcomes following bilateral (either ‘simultaneous’ or ‘staged’) versus unilateral hip arthroscopy for FAI. A systematic review of multiple electronic databases was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and checklist. All studies comparing simultaneous, staged and/or unilateral hip arthroscopy for FAI were eligible for inclusion. Case series, case reports and reviews were excluded. All study, patient and hip-specific data were extracted and analyzed. The Newcastle–Ottawa Scale was used to assess study quality. A meta-analysis was not performed due to heterogeneity among outcome measures. A total of six studies, including 722 patients (42.8% male) and 933 hips were eligible for inclusion. The mean age across patients was 35.5. The average time between staged procedures was 7.7 months. Four of the six studies were retrospective cohort studies, while the remaining two were prospective in nature. The overall quality of the eligible studies was found to be good. No significant difference was noted among patient-reported outcomes (modified Harris hip score, hip outcome score and non-arthritic hip score), visual analog scale, return to sport, traction time and complications between those undergoing bilateral (simultaneous or staged) versus unilateral hip arthroscopy. Based on the current available evidence, bilateral hip arthroscopy (whether simultaneous or staged) exhibits similar efficacy and safety when compared with unilateral hip arthroscopy. However, further prospective study is required to confirm this finding.

scholarly journals Development of the HOOSglobal to Assess Patient-Reported Outcomes in Patients Undergoing Hip Preservation Procedures

2018 ◽  
Vol 46 (4) ◽  
pp. 940-946 ◽  
Author(s):  
Cale A. Jacobs ◽  
Michael R. Peabody ◽  
Stephen T. Duncan ◽  
Ryan D. Muchow ◽  
Ryan M. Nunley ◽  
...  
Keyword(s):  
Los Angeles ◽  
Short Form ◽  
Periacetabular Osteotomy ◽  
Patient Reported Outcome ◽  
Harris Hip Score ◽  
Level Of Evidence ◽  
Patient Reported ◽  
Orthopaedic Community ◽  
Pro Tools ◽  
Modified Harris Hip Score

Background: The creation of a single patient-reported outcome (PRO) platform validated across hip preservation, osteoarthritis (OA), and total hip arthroplasty (THA) populations may reduce barriers and streamline the routine collection of PROs in clinical practice. As such, the purpose of this study was to determine if augmenting the Hip disability and Osteoarthritis Outcome Score–Joint Replacement (HOOS, JR) with additional HOOS questions would result in a PRO platform that could be used across a wider spectrum of hip patient populations. Hypothesis: The HOOS, JR would demonstrate a notable ceiling effect, but by augmenting the HOOS, JR with additional HOOS questions, a responsive PRO platform could be created. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Using preoperative and postoperative HOOS responses from a sample of 304 patients undergoing periacetabular osteotomy (PAO), additional items were identified to augment the HOOS, JR. The psychometric properties of a newly created PRO tool (HOOSglobal) were then compared with the HOOS, JR and other PRO instruments developed for patients with hip OA and/or undergoing THA. Results: By augmenting the HOOS, JR with 2 additional questions, the HOOSglobal was more responsive than all other included PRO tools and had significantly fewer maximum postoperative scores than the HOOS, JR ( P < .0001), HOOS–Physical Function Short form ( P < .0001), Western Ontario and McMaster Universities Osteoarthritis Index ( P = .02), University of California, Los Angeles activity scale ( P = .0002), and modified Harris Hip Score ( P = .04). The postoperative HOOSglobal score threshold associated with patients achieving the patient acceptable symptom state (PASS) was 62.5. Conclusion: The HOOSglobal is a valid and responsive PRO tool after PAO and may potentially provide the orthopaedic community with a PRO platform to be used across hip-related subspecialties. For patients undergoing PAO, a postoperative HOOSglobal score ≥62.5 was associated with patients achieving the PASS.

Patients With Borderline Hip Dysplasia Achieve Clinically Significant Outcome After Arthroscopic Femoroacetabular Impingement Surgery: A Case-Control Study With Minimum 2-Year Follow-up

2019 ◽  
Vol 47 (11) ◽  
pp. 2636-2645 ◽  
Author(s):  
Edward C. Beck ◽  
Benedict U. Nwachukwu ◽  
Jorge Chahla ◽  
Kyleen Jan ◽  
Timothy C. Keating ◽  
...  
Keyword(s):  
Hip Arthroscopy ◽  
Hip Dysplasia ◽  
Alpha Angle ◽  
Patient Reported Outcome ◽  
Harris Hip Score ◽  
Acetabular Coverage ◽  
Patient Reported ◽  
Clinically Significant ◽  
Modified Harris Hip Score ◽  
Preoperative Predictors

Background: There is a growing trend for hip arthroscopists to treat patients with borderline hip dysplasia (BHD) for femoroacetabular impingement syndrome (FAIS) without addressing the acetabular coverage. However, the literature of outcomes and failure rates for these patients is conflicting. Purpose: (1) To identify whether patients with BHD achieved 2-year similar patient-reported outcome, minimal clinically important difference (MCID), and patient acceptable symptomatic state (PASS) when compared with patients without BHD and (2) to identify predictors for achieving the MCID and PASS among patients with BHD who are undergoing hip arthroscopy for FAIS. Study Design: Cohort study; Level of evidence, 3. Methods: Data from consecutive patients who underwent primary hip arthroscopy with routine capsular closure for the treatment of FAIS between January 2012 and January 2017 were collected and retrospectively analyzed. Patients with BHD (lateral center-edge angle [LCEA], 20°-25°) were matched 2:1 by age, sex, and body mass index (BMI) to control patients with normal acetabular coverage (LCEA, >25°-40°). Patient-reported outcome, MCID, and PASS were compared between the groups. Multivariate logistic regression analysis identified significant predictors of achieving the MCID and PASS in the BHD group. Results: The MCID in the BHD group was defined as 9.2, 13.7, 8.5, and 15.2 for the Hip Outcome Score–Activities of Daily Living, Hip Outcome Score–Sport Specific, modified Harris Hip Score, and iHOT-12, respectively. Threshold scores for achieving the PASS in both groups were 87.9, 76.4, 78.1, and 60.0. A total of 112 patients were identified as having BHD (LCEA, 20°-25°) and were matched to 224 controls. Both groups saw statistically significant increases in score averages over the 2-year period; however, the differences between them were not statistically significant ( P > .05 for all). There was no statistical difference in the frequency of the BHD and non-BHD cohorts achieving the MCID on at least 1 threshold score (86.6% vs 85.6%, P = .837) and the PASS (78.6% vs 79.8%, P = .79). There was, however, a statistically significant difference between the rates of patients with and without BHD achieving the PASS on the modified Harris Hip Score threshold (62.5% vs 74.5%, P = .028). The final logistic models demonstrated that lower BMI (odds ratio [OR], 0.872; P = .029), lower preoperative alpha angle (OR, 0.965; P = .014), and female sex (OR, 3.647; P = .03) are independent preoperative predictors of achieving the MCID, while lower preoperative alpha angle (OR, 0.943; P = .018) and self-reported limp (OR, 18.53; P = .007) are independent preoperative predictors of achieving the PASS. Conclusion: Outcome improvements in patients with BHD who are undergoing arthroscopic treatment with capsular closure for FAIS are not significantly different from patients with normal acetabular coverage. Lower BMI, lower alpha angle, absence of limp, and female sex are preoperative predictors of achieving meaningful clinically significant outcome improvements in patients with BHD.

scholarly journals Is there a gender gap in outcomes after hip arthroscopy for femoroacetabular impingement? Assessment of clinically meaningful improvements in a prospective cohort

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0043
Author(s):  
Sergio Flores ◽  
Caitlin Chambers ◽  
Kristina Borak ◽  
Alan Zhang
Keyword(s):  
Femoroacetabular Impingement ◽  
Gender Gap ◽  
Hip Arthroscopy ◽  
Short Form ◽  
Patient Reported Outcome ◽  
Harris Hip Score ◽  
Power Calculation ◽  
Age Group ◽  
Patient Gender ◽  
Patient Reported

Objectives: Although patients have been found to have significant improvements after hip arthroscopy for femoroacetabular impingement (FAI), prior studies suggest women have worse outcomes compared to men. These previous studies lack comparisons of patient reported outcome (PRO) scores based on gender with respect to clinical significance measurements, including the minimal clinically important difference (MCID) and patient acceptable symptom state (PASS). Therefore, the purpose of this study is to evaluate outcomes following hip arthroscopy for FAI based on patient gender by prospectively assessing changes in PRO scores, MCID, and PASS. Methods: Women and men undergoing hip arthroscopy for FAI were prospectively enrolled and preoperative radiographic and intra-operative findings were collected. The cohort was stratified based on self-identified patient gender so the term gender as well as the terms women and men were used to describe the patients as opposed to sex and the terms female and male. Patients completed the following PRO surveys before surgery and 2-years postoperatively: modified Harris Hip Score (mHHS), Hip disability and Osteoarthritis Outcome Score (HOOS), and the 12-Item Short Form Health survey (SF-12). Mean scores and the percentage of patients reaching MCID and PASS were analyzed. An a priori power calculation was performed which determined 42 hips in each group were needed to adequately power the study to 95%. Results: A total of 131 hips, from 72 women and 59 men were included. The mean ± SD age for women and men was 34.2 ± 9.5 vs 35.8 ± 10.3 years, respectively; P= .347 and body mass index (BMI) of 24.9 ± 4.4 vs 25.5 ± 3.3 kg/m2, respectively; P= .379. Women had smaller preoperative alpha angles (59.1 vs 63.7, respectively; P< 0.001) and lower acetabular cartilage injury grade (6.9% vs 22.0% with grade 4 injury, respectively; P= 0.013). Both women and men achieved equivalent significant improvements in PRO scores after surgery (PRO scores increased 18.4 to 45.1 points for mHHS and HOOS). Women and men reached PASS for mHHS at similar rates (76.4% and 77.2%, respectively; P=0.915). MCID was also achieved at similar rates between women and men for all scores (ranged 61.4% to 88.9%) except HOOS-ADL in which a higher percentage of women reached MCID compared to men (79.2% vs 62.7%, respectively; P= .037). Additional stratification by age group using the median cohort age of 34 showed no significant differences in PRO improvement based on age group for each gender. Conclusions: Women can achieve clinically meaningful improvements in patient reported outcomes scores after hip arthroscopy for FAI. Compared to men, women demonstrated equivalent high rates of achieving MCID and PASS at 2 years following surgery. [Table: see text]

Acetabular microfracture in hip arthroscopy: clinical outcomes with minimum 5-year follow-up

2018 ◽  
Vol 28 (6) ◽  
pp. 649-656 ◽  
Author(s):  
Benjamin G Domb ◽  
Danil Rybalko ◽  
Brian Mu ◽  
Jody Litrenta ◽  
Austin W Chen ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Hip Arthroscopy ◽  
Patient Reported Outcomes ◽  
Harris Hip Score ◽  
Significant Deterioration ◽  
Patient Reported ◽  
Outcome Tool ◽  
Modified Harris Hip Score ◽  
Mid Term Results

Introduction: There is a paucity in the literature regarding mid-term results of microfracture in hip arthroscopy. We aim to assess 5-year outcomes of patients who underwent acetabular microfracture for full-thickness chondral lesions as a part of hip arthroscopy. Methods: Between August 2008 and September 2011, data were prospectively gathered for patients undergoing acetabular microfracture during hip arthroscopy with minimum 5-year follow-up. All patients were assessed pre- and postoperatively, with modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score – Sports Specific Subscale (HOS-SSS), and visual analog scale (VAS). International Hip Outcome Tool (iHOT-12) and satisfaction were collected postoperatively. Exclusion criteria included previous hip conditions, or preoperative Tönnis grade ≥2. Results: Fifty three hips were eligible for this study. Of these, 43 (81.1%) hips in 42 patients had follow-up. The study group had a male majority (65.1%) and an average age of 44.4 ± 9.5 years. There was statistically significant improvement in all patient-reported outcomes (PROs) and VAS at follow-up. Patient satisfaction was 7.6 ± 2.6. A comparison of 2-year to minimum 5-year follow-up results identified no statistically significant deterioration in PROs, VAS, and patient satisfaction. Survivorship was 72.1% with 12 patients converted to total hip arthroplasty (THA). 4 patients (10.8%) underwent secondary arthroscopy. Conclusions: In the mid-term, microfracture as a part of hip arthroscopy demonstrated favourable outcomes and 72% survivorship. Careful patient selection is warranted to limit the risk of conversion to THA.

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